Hip fractures may cause morbidity and mortality in persons, including, for example, elderly persons. With the progressive increase in the number of elderly persons in the United States, a concurrent surge in hip fractures is occurring. Hip fracture in elderly persons may result from a fall on the hip area. For example, Cummings et al. in “A Hypothesis: The Causes of Hip Fractures”, Journal of Gerontology: Medical Sciences, Vol. 44, No. 4 (1989), state that about 80 to 90% of hip fractures in elderly persons are due to falls, and that fewer than 10% occur before the fall. Consequently, hip protecting devices have been advocated to reduce the risk of sustaining a hip fracture.
Hip protective devices should provide both an effective and cost-saving strategy for reducing the risk of hip fractures. To be effective, however, a hip protecting device must be worn. A major issue is patient non-compliance and/or non-adherence with wearing of such hip protecting devices. It is has been found that the non-compliance in community and institutional settings ranges from 37% to 72%.
There may be several reasons why persons do not always wear a hip protecting device when instructed to do so. Reasons for non-compliance may include, for example, discomfort (e.g., too tight and/or a poor fit), and the extra effort and time required to put on and adjust the hip protecting device. It is believed that patient compliance would be substantially increased if hip protecting devices were more comfortable and provided a better fit. Patient compliance may be increased if hip protecting devices are presented in a form that those in need of such devices would be less inclined to resist the wearing of the device, due to, for example, vanity concerns or not wanting to admit the time has come to wear such a device.
There are hip protecting devices, for example, in which the device is worn underneath clothing because the wearer may not consider the protecting device aesthetically pleasing. However, in the past 10 years or so, it is understood that a very large proportion of the wearers need to be able to take the device off, sometimes urgently, such as in a need to visit the toilet, and this cannot be done with the type of the hip protector that is worn in or as underwear. This even applies if the caregiver has to take off the garment.
Wearers of hip protectors may have different capabilities with respect to possible movements of their limbs and agility. Certain existing hip protectors may not accommodate such individual needs and/or capabilities of the wearer, particularly if the wearer cannot move certain body parts in a particular direction, in agile fashion. For example, the wearer may have arthritis or muscular weakness in the hands. It has also been understood that certain existing hip protecting devices are not easily removed or put on by the wearer or the care giver.
The material of certain existing hip protecting devices using pads can stretch and therefore allow for undesired movement of the pads with respect to a particular desired area to be protected (e.g., pads that are included in a sweatpants arrangement). For example, if a person falls off a couch, the friction from contact with the couch may cause the padding of the hip protecting device to slide away from the point to be protected.
U.S. Pat. No. 5,545,128 purports to relate to a garment worn underneath clothing for bone fracture prevention during impact from a fall, in which the undergarment has an horseshoe-shaped pad arrangement for shunting a substantial portion of impact energy from the vulnerable region to the soft tissue region. However, such a design rests on the faulty notion that only falls with an impact at right angles to the greater trochanter cause hip fractures, which is not accurate. There are many other angles at which persons may fall. At some angles, contact will not be made near the greater trochanter. For example, one may fall flat backwards or half sideways on the buttocks. Accordingly, unless the fall occurs directly on the entire horseshoe-shaped pad, the thixotropy (hardening due to impact on the protective fluid/solid) will not occur fast enough, and the device is likely to do more harm than good. Moreover, the pads, which are about one inch thick, increase the perceived width of the wearer and thus may be esthetically unacceptable to the wearer. Moreover, the horseshoe-shaped design and the direct adherence to the skin is considered an impractical solution. Hence, the device discussed in U.S. Pat. No. 5,545,128 is understood to be functionally deficient, uncomfortable, or impractical for certain wearers, such as, for example, older persons.
Furthermore, another pad arrangement, in which the pads are fixed in a tight undergarment with straps around the legs and waist so that the pads can be held precisely over the greater trochanter, is not likely to be usable by an older person with arthritic fingers.
Certain hip protecting devices, which are designed to be worn underneath clothing, may include plastic shields or foam pads that may be held in place at the hips with specially designed underwear. However, such pads may provide only limited protection. For example, such pads do not protect from a rearward fall. In the human pelvis there are two large hip bones, each consisting of three fused bones, the illium, ischium, and pubis. The hip bones form a ring around a central cavity. The fused terminal segments of the spine, known as the sacrum and coccyx, connect the hip bones at the back of the central cavity; a fibrous band connects them at the front. A backward fall may cause injury or fracture of sacrum and/or coccyx. Moreover, with the internal force transmission occurring from bone to bone, falling backwards can not only hurt the sacrum and coccyx but hard impact on them can be passed onto other bones.